The Hindu : Kerala News : Government intervention needed for quality service

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Sunday, Aug 06, 2006

Kerala

Kerala

Government intervention needed for quality service

Over the years, the State has witnessed the mushrooming of scanning and X-ray units. According to a Health Department report, nearly 40 per cent of these units have no licence and are operating in violation of safety and quality norms as stipulated by the Government. How can we check unscrupulous elements from entering this vital element in the health sector? Our readers respond:

Introduce regulations

Appropriate action to close down scanning and X-ray units that operate without licence should be taken. One reason for the mushrooming of these units is the high cost of such tests, which makes patients turn to those who offer lower rates for them. The high cost is said to be the result of percentage of commission that goes to the doctor who recommends a particular unit. It is also alleged that scanning is recommended unnecessarily. Therefore, some sort of regulation in the prices should be introduced. The practice of giving commission to doctors on scanning and sale of medicine should be banned by law or regulation.

A. Jacob Sahayam

Thiruvananthapuram

Government should set up units

The State has seen tremendous growth in the number of scanning and X-ray units over the past few years. A majority of such centres are in the rural areas. Huge sums of money are extracted from the common people and their right to information regarding their health is violated.

At times, even units with licence do not follow the safety and quality standards. A special panel should be formed by the Government to collect information regarding these illegal units. The Health Department should join hands with the police to close down these illegal units. Periodic checks should be undertaken to verify whether they use standardised equipment and their employees are well trained.

The Government must set up X-ray and scanning units, depending on the population and demand of the people, satisfying the required standards. Awareness programmes should be held to make the people aware of such illegal units. The responsibility to report operation of any such unit lies with the people.

K. Manu

Thiruvananthapuram

Monitoring force

The mushrooming of uncertified scanning and X-ray units will have a disastrous impact on public health. The test results from such centres will put the health of thousands at stake. They pose a grave threat to the credibility of the field of medicine, as correct diagnosis determines the appropriate treatment.

The Government should take emergency action to nip this evil in the bud itself. Licence and quality certification must be made mandatory for the testing centres. A special force should be constituted to conduct inspections throughout the State and stringent punishment should be handed out to the guilty.

The public can play a vital role in combating this menace.

Mohammed Riyaz A

Thiruvananthapuram

Monitor the units

While giving licence to start scanning and X-ray centres, the Government should lay down clear and unambiguous rules and regulations on all matters such as minimum space for the centres to function, staff requirement, their qualification, cost for each item etc. A squad under the Health Department should be formed to ensure that the centres are run in accordance with the regulations stipulated. Defaulters should be booked and fined. Constant vigil is mandatory to curb the unauthorised growth of such centres.

P. Achuthan

Thiruvananthapuram

Ensure quality

The attitude of patients has contributed to the mushrooming of scanning centres. Nowadays, patients do not trust doctors who do not recommend scanning or X-ray. There is a misconception that only scanning and other tests will help the doctors arrive at the right diagnosis. But most of the patients are ignorant about the adverse effects of such tests. Doctors should make the patients aware of their long-term effects.

Tests held in centres in violation of safety and quality norms pose a grave threat. There are many private hospitals which insist that doctors recommend tests even when they are not necessary. Doctors who have private clinics prescribe tests to be conducted at certain labs from where they get a share of commission. No law can curb such malpractices.

What can be done is to ensure the quality of the machines at the centres before issuing licences to them. Measures should be taken to close down centres that do not follow the norms.

Archana V

Kollam

Augment facilities

Since treatment is free in Government hospitals, few avail themselves of the facilities there for these are thought to be for the financially backward. Those well-off go to private hospitals even for small ailments.

X-ray and scanning are invariably prescribed for all those who go to private hospitals as most of the scanning and X-ray centres are owned by doctors.

The Government should provide scanning and X-ray facilities in all hospitals and a nominal fee should be collected from below poverty line patients. Nothing should be free for those who are above the poverty line.

Hospital authorities should ensure that all machines and equipment are in working condition so that patients are not driven to private scanning and

X-ray centres.

K.P. Karunakaran Nair

Thiruvananthapuram

Vigilance needed

The health sector has become an attractive area of investment for unscrupulous elements. Several scanning centres, X-ray units and clinics have come up in the State without licence or proper infrastructural facilities. They are functioning against safety and quality norms.

A good number of doctors unnecessarily recommend patients to these scanning centres and get a share of commission from these units. The public should be on the lookout against such centres.

The Health Department in the State has a major role to play in closing down these units.

Only licensed lab technicians should be allowed to practise. Health squads should conduct frequent inspections to checks all malpractices in the sector.

Shreya A.S

Thiruvananthapuram

Make public the legal units

Flying squads should be deployed to monitor the centres that use X-rays and scanning units. Those that do not observe the stipulated norms for such units should be prosecuted. The units should be closed down.

In order to increase public awareness, the Health Department should publicise the names of units that have proper licence. This information will be of great help to the patients.

N. Ramachandran

Vakkom

Enforce registration

Clinical labs in our cities have multiplied in such a manner that people are at a loss to differentiate the real ones from the fake. The existence of some of these unrecognised units depends on the unreliability of labs in Government hospitals and medical colleges. It is also a matter of concern that some doctors act as `suppliers' to these units. The only possible remedy is strict Government control over them.

Registration of these clinical labs is a must. Medical attendants should be discouraged from referring their patients to unauthorised clinical labs for monetary benefit.

A standardised fee structure for all tests should be introduced to avoid corruption and exploitation of the people.

Ravikumar N

Thiruvananthapuram

Publicise licensed units

Mushrooming of scanning centres and X-ray units that do not maintain quality and safety norms is dangerous to society. This trend needs to be checked and the culprits booked. A list of licensed units in an area should be displayed at a prominent place such as a leading hospital or health centre. The possibility of providing adequate facility on the hospital premises should be explored by the hospital advisory committee. Doctors can playa vital role in helping patients and their caretakers identify licensed X-ray and scanning units. Awareness among the people will definitely result in an improvement in the situation.

R.P. Pillai

Alappuzha

Exercise caution

Patients should take utmost care when approaching a scanning centre or like institution (laboratories, for instance) for their services. They should ensure that these units have proper licences. If they are guilty of unauthorised activity, the authorities should take legal action against them.

P. Sankaranarayanan

Kochi

Conduct surprise checks

Barring a few, most of the scanning and X-ray units in the private sector lack well-qualified and experienced technicians, laboratory facilities and other modern equipment that are essential for true and credible analytical study.

The result prepared by such units often result in wrong diagnosis, which adversely affects the health of the patient. Apprehension over the disease prompts the patient to consult another physician, who too advises fresh scan and X-ray reports.

In order to find a lasting solution to the problem, the intervention of the Government is necessary. The Health Department's role in this regard is vital. Surprise checks should be conducted by the authorities, who include experts in the field, at the existing units.

On the basis of their reports, the units that are unlawful or violate norms and stipulations should be immediately closed down. Similarly, the health authority's consent stating that the proposed unit has all the laboratory and theatre requisites should be made mandatory for issue of new licence. In addition, legal action must be taken against those who prepare analytical report frivolously, if this is proved on further study or investigation.

At the same time, the units that operate as per report should be felicitated with awards and merit certificates. Publication of names of meritorious units in each district through the mass media or other means is also useful for the public.

V. Viswanathan Nambiar

Thrissur

Introduce restrictions

Scan centres and laboratories are opened without any criteria at all. No one bothers whether they are licensed or not. Nor are the authorities interested in knowing whether the results from these medical institutions are correct or not, and whether they have sufficient and efficient staff and the required equipment. Some restrictions should be brought in as the results of tests conducted at such units decide the fate of a patient.

S.N. Thiruvazhiode

Kochi

Thiruvananthapuram

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